A prolonged course of antiviral medication may prevent vision damage associated with ocular shingles, according to new research from the United States.
Study co-chair Dr Benny Jeng, from the University of Pennsylvania, said until now, there has been “no proven long-term treatment for new, worsening, or repeated episodes of this disease”.1
Ocular shingles begins in the nerve connecting the brain to the eye. This is called herpes zoster ophthalmicus (HZO) and can result in keratitis, iritis, and inflammation in other parts of the eye.
For patients who had recurrences or new findings of HZO, there was never a clear course of treatment to reliably prevent complications such as vision loss, study authors said.
The researchers showed that using valacyclovir for a year can decrease the risk of new or worsening eye disease by 26% at 18 months after initiating treatment.
The Zoster Eye Disease Study (ZEDS) was designed and led by Professor Elisabeth J. Cohen, from New York University after she was affected by shingles-related vision loss years ago. It ran for eight years in the US, Canada, and New Zealand.
The study examined the long-term use of the existing antiviral treatment valacyclovir, which is already used to initially treat any case of shingles, albeit only for seven to 10 days.
The researchers showed that using valacyclovir for a year can decrease the risk of new or worsening eye disease by 26% at 18 months after initiating treatment.
Patients treated with valacyclovir were also 30% less likely than those not receiving the treatment to have multiple HZO flare-ups at a year or 18 months later.
“We hope that our work creates a relatively simple path toward preventing vision changes that can be life-altering,” said Dr Jeng. “With this drug already being part of the regular clinical treatment for shingles, we don’t envision significant barriers to making this a standard of treatment.”
Reference
- Penn Medical News, Long-term antiviral use is key to ocular shingles treatment (news release, 21 October 2024), available at: pennmedicine.org/news/news-releases/2024/october/long-term-antiviral-use-is-key-to-ocular-shingles-treatment [accessed 24 October 2024].
